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Title
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Functional respiratory imaging of the airways in the acute respiratory distress syndrome
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Author
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Abstract
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| Background: Alveolar flooding and airway obstruction are present in the acute respiratory distress syndrome. The impact of positive end- expiratory pressure on regional airway aeration has not been described. Aim: To assess bronchial and lung recruitment and distension during an incremental positive endexpiratory pressure trial in patients with acute respiratory distress syndrome. Methods: Six patients underwent lung and airway imaging at four positive end-expiratory pressure levels in a cohort trial. Images were post-processed by means of Functional Respiratory Imaging. This technique offers 3-dimensional visualisation and quantification of patients' airway and lung geometry on a regional level. Results: With increasing positive end-expiratory pressure from 0 to 20 cmH2O, the median bronchial recruitment was 151% and the median bronchial distension 43%. Non-aerated lower lobes bronchi had more bronchial volume increase at high positive end-expiratory pressure than partially aerated upper lobes bronchi. Lung recruitment tended to be higher in patients with non-focal acute respiratory distress syndrome. In two patients, bronchial volume increase at high positive end-expiratory pressure largely exceeded bronchial volume increase observed in matched healthy control subjects at total lung capacity, suggesting severe bronchial over-distension. Conclusions: In early acute respiratory distress syndrome, Functional Respiratory Imaging gives an innovative insight into the relationship between positive end-expiratory pressure-induced bronchial distension and recruitment, positive end-expiratory pressure-induced lung recruitment and hyperinflation and lung morphology. C 2020 Socie ' te ' francaise d'anesthe ' sie et de re ' animation (Sfar). Published by Elsevier Masson SAS. All rights reserved. |
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Language
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English
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Source (journal)
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Anaesthesia, critical care & pain medicine / Société française d'anesthésie et de réanimation. - 2015, currens
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Publication
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2020
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ISSN
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2352-5568
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DOI
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10.1016/J.ACCPM.2019.10.017
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Volume/pages
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39
:2
(2020)
, p. 207-213
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ISI
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000531576000015
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Pubmed ID
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32044302
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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